Provider Demographics
NPI:1376808840
Name:CENTRAL SURGICAL CENTER, LLC
Entity Type:Organization
Organization Name:CENTRAL SURGICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KLONEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-682-3030
Mailing Address - Street 1:462 W CENTRAL PKWY
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-2415
Mailing Address - Country:US
Mailing Address - Phone:407-682-3030
Mailing Address - Fax:
Practice Address - Street 1:462 W CENTRAL PKWY
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2415
Practice Address - Country:US
Practice Address - Phone:407-682-3030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL12000065042174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty